EFFICACY
Additional subgroup results are available below
Additional subgroup results are available below
In the treatment of mNSCLC with no EGFR mutations or ALK genomic tumor aberrations
Preplanned OS analysis: 14 months (95% CI, 11.7-16.1) median OS with the POSEIDON Regimen and 11.7 months (95% CI, 10.5-13.1) with platinum-based CT (HR=0.77; 95% CI, 0.65-0.92; P=0.003)1-3*†
Median OS HR was consistent from preplanned analysis to post-hoc analysis at ~5 years4
OS IN ITT: POST-HOC ANALYSIS AT ~5 YEARS4
NCCN CATEGORY 1
National Comprehensive Cancer Network® (NCCN®)—Category 1
Durvalumab (IMFINZI®) + tremelimumab-actl (IMJUDO®) and platinum-based chemotherapy is a Category 1, recommended systemic therapy for metastatic NSCLC with PD-L1 <1%5‡
Study design: The POSEIDON trial was a Phase III, global, randomized (1:1:1), open-label, multicenter, clinical trial in 1013 patients with nonsquamous and squamous metastatic NSCLC. Eligible patients were treatment-naïve for metastatic disease, with no EGFR mutations or ALK genomic tumor aberrations, had an ECOG performance status of 0 or 1 and were stratified by PD-L1 (TC <50% vs TC ≥50%), histology, and disease stage (IVA, IVB). Patients received IMFINZI + IMJUDO and platinum-based chemotherapy* (n=338), platinum-based chemotherapy* (n=337), or IMFINZI + platinum-based chemotherapy* (unapproved use in mNSCLC; n=338). The major efficacy outcome measures were PFS and OS of IMFINZI + IMJUDO and platinum-based chemotherapy vs platinum-based chemotherapy alone. Secondary outcome measures included ORR and DoR. PFS, ORR, and DoR were assessed using BICR according to RECIST v1.1.1-3
*Platinum-based CT is given Q3W for 4 cycles. Options include pemetrexed + carboplatin/cisplatin (nonsquamous); gemcitabine + carboplatin/cisplatin (squamous); or nab-paclitaxel + carboplatin (either histology). Starting in Week 12, nonsquamous patients who received pemetrexed as part of the first-line regimen can continue pemetrexed maintenance Q4W until disease progression or intolerable toxicity.1,2
†The preplanned OS analysis was conducted after 536 deaths for 79.4% maturity.5
‡NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
OS IN PRESPECIFIED SUBGROUPS: POST-HOC ANALYSIS AT ~5 YEARS4,7
SWIPE FOR MORE
AJCC=American Joint Committee on Cancer; ALK=anaplastic lymphoma kinase; BICR=blinded independent central review; CI=confidence interval; CT=chemotherapy; DoR=duration of response; ECOG=Eastern Cooperative Oncology Group; EGFR=epidermal growth factor receptor; HR=hazard ratio; ITT=intent to treat; KRAS=Kirsten rat sarcoma viral oncogene homolog; mNSCLC=metastatic non-small cell lung cancer; NCCN=National Comprehensive Cancer Network® (NCCN®); NSCLC=non-small cell lung cancer; ORR=objective response rate; OS=overall survival; PD-1=programmed cell death protein 1; PD-L1=programmed death-ligand 1; PFS=progression-free survival; PS=performance status; Q3W=every 3 weeks; Q4W=every 4 weeks; RECIST=Response Evaluation Criteria in Solid Tumors; STK11=serine/threonine kinase 11; TC=tumor cell.
MEDIAN PFS IN ITT: PREPLANNED ANALYSIS1-3
6.2 months
(95% CI, 5.0-6.5)
with the
POSEIDON Regimen
4.8 months
(95% CI, 4.6-5.8)
with platinum-based CT
HR=0.72 (95% CI, 0.60-0.86; P=0.00031)
CI=confidence interval; CT=chemotherapy; DoR=duration of response; HR=hazard ratio; ITT=intent to treat; KRAS=Kirsten rat sarcoma viral oncogene homolog; OS=overall survival; ORR=objective response rate; PD-L1=programmed death-ligand 1; PFS=progression-free survival; STK11=serine/threonine kinase 11.
ORR IN ITT: POST-HOC ANALYSIS AT INITIAL READOUT1-3
MEDIAN DoR IN ITT: PREPLANNED ANALYSIS1-3
*Among patients with a confirmed response.
CI=confidence interval; CT=chemotherapy; DoR=duration of response; KRAS=Kirsten rat sarcoma viral oncogene homolog; ITT=intent to treat; NR=not reached; ORR=objective response rate; OS=overall survival; PD-L1=programmed death-ligand 1; PFS=progression-free survival; STK11=serine/threonine kinase 11.
OS IN NONSQUAMOUS KRAS-MUTANT: POST-HOC ANALYSIS AT ~5 YEARS4
CI=confidence interval; CT=chemotherapy; HR=hazard ratio; KRAS=Kirsten rat sarcoma viral oncogene homolog; OS=overall survival; PD-L1=programmed death-ligand 1; STK11=serine/threonine kinase 11.
MEDIAN PFS IN NONSQUAMOUS KRAS-MUTANT: POST-HOC ANALYSIS
AT INITIAL READOUT8
8.5 months
(95% CI, 6.0-NE)
with the
POSEIDON Regimen (n=60)
4.7 months
(95% CI, 4.4-6.5)
with platinum-based CT (n=53)
HR=0.57 (95% CI, 0.35-0.92)
CI=confidence interval; CT=chemotherapy; HR=hazard ratio; KRAS=Kirsten rat sarcoma viral oncogene homolog; mNSCLC=metastatic non-small cell lung cancer; NE=not estimable; PD-L1=programmed death-ligand 1; PFS=progression-free survival; STK11=serine/threonine kinase 11.
ORR IN NONSQUAMOUS KRAS-MUTANT: POST-HOC ANALYSIS AT INITIAL READOUT8
MEDIAN DoR IN NONSQUAMOUS KRAS-MUTANT: POST-HOC ANALYSIS AT INITIAL READOUT8
*Patients who have both a baseline and post-baseline target lesion measurement.
CI=confidence interval; CT=chemotherapy; DoR=duration of response; KRAS=Kirsten rat sarcoma viral oncogene homolog; mNSCLC=metastatic non-small cell lung cancer; NE=not estimable; NR=not reached; ORR=objective response rate; PD-L1=programmed death-ligand 1; STK11=serine/threonine kinase 11.
OS IN NONSQUAMOUS STK11-MUTANT: POST-HOC ANALYSIS AT ~5 YEARS4
CI=confidence interval; CT=chemotherapy; HR=hazard ratio; KRAS=Kirsten rat sarcoma viral oncogene homolog; OS=overall survival; PD-L1=programmed-death ligand 1; STK11=serine/threonine kinase 11.
MEDIAN PFS IN NONSQUAMOUS STK11-MUTANT: POST-HOC ANALYSIS
AT INITIAL READOUT8
6.4 months
(95% CI, 4.7-13.8)
with the
POSEIDON
Regimen (n=31)
4.6 months
(95% CI, 2.9-6.4)
with platinum-based CT (n=22)
HR=0.47 (95% CI, 0.23-0.93)
CI=confidence interval; CT=chemotherapy; HR=hazard ratio; KRAS=Kirsten rat sarcoma viral oncogene homolog; mNSCLC=metastatic non-small cell lung cancer; PD-L1=programmed death-ligand 1; PFS=progression-free survival; STK11=serine/threonine kinase 11.
ORR IN NONSQUAMOUS STK11-MUTANT: POST-HOC ANALYSIS AT INITIAL READOUT8
MEDIAN DoR IN NONSQUAMOUS STK11-MUTANT: POST-HOC ANALYSIS AT INITIAL READOUT8
*Patients who have both a baseline and post-baseline target lesion measurement.
CI=confidence interval; CT=chemotherapy; DoR=duration of response; KRAS=Kirsten rat sarcoma viral oncogene homolog; mNSCLC=metastatic non-small cell lung cancer; NE=not estimable; ORR=objective response rate; STK11=serine/threonine kinase 11.
~5-year post-hoc analysis of prespecified subgroup; 19% reduction in the risk of death (HR=0.81; 95% CI, 0.62-1.05) in patients with PD-L1 <1% in the POSEIDON Regimen
OS IN PRESPECIFIED SUBGROUPS: POST-HOC ANALYSIS AT ~5 YEARS4,7
SWIPE FOR MORE
CI=confidence interval; CT=chemotherapy; HR=hazard ratio; KRAS=Kirsten rat sarcoma viral oncogene homolog; OS=overall survival; PD-L1=programmed death-ligand 1; STK11=serine/threonine kinase 11.


IMFINZI is indicated for the treatment of adult patients with unresectable Stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy.
IMFINZI, in combination with IMJUDO and platinum-based chemotherapy, is indicated for the treatment of adult patients with metastatic NSCLC with no sensitizing epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) genomic tumor aberrations.
IMFINZI, in combination with etoposide and either carboplatin or cisplatin, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC).
IMFINZI, in combination with gemcitabine and cisplatin, is indicated for the treatment of adult patients with locally advanced or metastatic biliary tract cancer (BTC).
IMFINZI in combination with IMJUDO is indicated for the treatment of adult patients with unresectable hepatocellular carcinoma (uHCC).
There are no contraindications for IMFINZI® (durvalumab) or IMJUDO® (tremelimumab-actl).
IMFINZI is indicated for the treatment of adult patients with unresectable Stage III non-small cell lung cancer (NSCLC) whose disease has not
There are no contraindications for IMFINZI® (durvalumab) or IMJUDO® (tremelimumab-actl).
Important immune-mediated adverse reactions listed under Warnings and Precautions may not include all possible severe and fatal immune-mediated reactions. Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue. Immune-mediated adverse reactions can occur at any time after starting treatment or after discontinuation. Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Evaluate clinical chemistries including liver enzymes, creatinine, adrenocorticotropic hormone (ACTH) level, and thyroid function at baseline and before each dose. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate. Withhold or permanently discontinue IMFINZI and IMJUDO depending on severity. See USPI Dosing and Administration for specific details. In general, if IMFINZI and IMJUDO requires interruption or discontinuation, administer systemic corticosteroid therapy (1 mg to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose immune-mediated adverse reactions are not controlled with corticosteroid therapy.
IMFINZI, as a single agent, is indicated for the treatment of adult patients with unresectable Stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (cCRT).
IMFINZI in combination with platinum-containing chemotherapy as neoadjuvant treatment, followed by IMFINZI continued as a single agent as adjuvant treatment after surgery, is indicated for the treatment of adult patients with resectable (tumors ≥4 cm and/or node positive) NSCLC and no known epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements.
IMFINZI, in combination with IMJUDO and platinum-based chemotherapy, is indicated for the treatment of adult patients with metastatic NSCLC with no sensitizing EGFR mutations or ALK genomic tumor aberrations.
IMFINZI, as a single agent, is indicated for the treatment of adult patients with limited-stage small cell lung cancer (LS-SCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (cCRT).
IMFINZI, in combination with etoposide and either carboplatin or cisplatin, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC).
IMFINZI, in combination with gemcitabine and cisplatin, is indicated for the treatment of adult patients with locally advanced or metastatic biliary tract cancer (BTC).
IMFINZI in combination with IMJUDO is indicated for the treatment of adult patients with unresectable hepatocellular carcinoma (uHCC).
IMFINZI in combination with carboplatin and paclitaxel followed by IMFINZI as a single agent is indicated for the treatment of adult patients with primary advanced or recurrent endometrial cancer that is mismatch repair deficient (dMMR) as determined by an FDA-approved test.
IMFINZI in combination with gemcitabine and cisplatin as neoadjuvant treatment, followed by single agent IMFINZI as adjuvant treatment following radical cystectomy, is indicated for the treatment of adult patients with muscle-invasive bladder cancer (MIBC).
IMFINZI in combination with fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) as neoadjuvant and adjuvant treatment, followed by single agent IMFINZI, is indicated for the treatment of adult patients with resectable gastric or gastroesophageal junction adenocarcinoma (GC/GEJC).
IMFINZI and IMJUDO can cause immune-mediated pneumonitis, which may be fatal. The incidence of pneumonitis is higher in patients who have received prior thoracic radiation.
IMFINZI with IMJUDO and platinum-based chemotherapy can cause immune-mediated colitis, which may be
fatal.
IMFINZI and IMJUDO can cause immune-mediated colitis that is frequently associated with diarrhea.
Cytomegalovirus (CMV) infection/reactivation has been reported in patients with corticosteroid-refractory
immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup
to exclude alternative etiologies.
IMFINZI and IMJUDO can cause immune-mediated hepatitis, which may be fatal.
IMFINZI and IMJUDO can cause immune-mediated nephritis.
IMFINZI and IMJUDO can cause immune-mediated rash or dermatitis. Exfoliative dermatitis, including Stevens-Johnson Syndrome (SJS), drug rash with eosinophilia and systemic symptoms (DRESS), and toxic epidermal necrolysis (TEN), has occurred with PD-1/L-1 and CTLA-4 blocking antibodies. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-exfoliative rashes.
IMFINZI in combination with IMJUDO can cause immune-mediated pancreatitis. Immune-mediated pancreatitis occurred in 2.3% (9/388) of patients receiving IMFINZI and IMJUDO, including Grade 4 (0.3%) and Grade 3 (1.5%) adverse reactions.
The following clinically significant, immune-mediated adverse reactions occurred at an incidence of less than 1% each in patients who received IMFINZI and IMJUDO or were reported with the use of other immune-checkpoint inhibitors.
IMFINZI and IMJUDO can cause severe or life-threatening infusion-related reactions. Monitor for signs and symptoms of infusion-related reactions. Interrupt, slow the rate of, or permanently discontinue IMFINZI and IMJUDO based on the severity. See USPI Dosing and Administration for specific details. For Grade 1 or 2 infusion-related reactions, consider using pre-medications with subsequent doses.
Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a PD-1/L-1 blocking antibody. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease (VOD) after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between PD-1/L-1 blockade and allogeneic HSCT. Follow patients closely for evidence of transplant-related complications and intervene promptly. Consider the benefit versus risks of treatment with a PD-1/L-1 blocking antibody prior to or after an allogeneic HSCT.
Based on their mechanism of action and data from animal studies, IMFINZI and IMJUDO can cause fetal harm when administered to a pregnant woman. Advise pregnant women of the potential risk to a fetus. In females of reproductive potential, verify pregnancy status prior to initiating IMFINZI and IMJUDO and advise them to use effective contraception during treatment with IMFINZI and IMJUDO and for 3 months after the last dose of IMFINZI and IMJUDO.
There is no information regarding the presence of IMFINZI and IMJUDO in human milk; however, because of the potential for serious adverse reactions in breastfed infants from IMFINZI and IMJUDO, advise women not to breastfeed during treatment and for 3 months after the last dose.
The safety and effectiveness of IMFINZI and IMJUDO have not been established in pediatric patients.
IMFINZI, as a single agent, is indicated for the treatment of adult patients with unresectable Stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (cCRT).
IMFINZI in combination with platinum-containing chemotherapy as neoadjuvant treatment, followed by IMFINZI continued as a single agent as adjuvant treatment after surgery, is indicated for the treatment of adult patients with resectable (tumors ≥4 cm and/or node positive) NSCLC and no known epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements.
IMFINZI, in combination with IMJUDO and platinum-based chemotherapy, is indicated for the treatment of adult patients with metastatic NSCLC with no sensitizing EGFR mutations or ALK genomic tumor aberrations.
IMFINZI, as a single agent, is indicated for the treatment of adult patients with limited-stage small cell lung cancer (LS-SCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (cCRT).
IMFINZI, in combination with etoposide and either carboplatin or cisplatin, is indicated for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC).
IMFINZI, in combination with gemcitabine and cisplatin, is indicated for the treatment of adult patients with locally advanced or metastatic biliary tract cancer (BTC).
IMFINZI in combination with IMJUDO is indicated for the treatment of adult patients with unresectable hepatocellular carcinoma (uHCC).
IMFINZI in combination with carboplatin and paclitaxel followed by IMFINZI as a single agent is indicated for the treatment of adult patients with primary advanced or recurrent endometrial cancer that is mismatch repair deficient (dMMR) as determined by an FDA-approved test.
IMFINZI in combination with gemcitabine and cisplatin as neoadjuvant treatment, followed by single agent IMFINZI as adjuvant treatment following radical cystectomy, is indicated for the treatment of adult patients with muscle-invasive bladder cancer (MIBC).
IMFINZI in combination with fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) as neoadjuvant and adjuvant treatment, followed by single agent IMFINZI, is indicated for the treatment of adult patients with resectable gastric or gastroesophageal junction adenocarcinoma (GC/GEJC).
Please see Full Prescribing Information including Medication Guide for IMFINZI and IMJUDO.
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